Fundamentals- Ch. 21

A nurse is providing anticipatory guidance to the parents of a 2 1/2-year-old girl. To foster the development of autonomy, which instruction would the nurse include?

"Encourage the child to dress herself."

A nurse is working in a pediatric clinic. The parent has brought in the 2-year-old toddler for a well-child checkup. The parent asks what the common health problems are common for this age. The nurse's correct reply includes which of the following?

Accidents

Applying the principles of growth and development, place the following body parts in the correct sequence as they would develop from first to last.

Brain Heart Intestine Legs Feet Growth and development follow regular and predictable trends. Cephalocaudal (proceeding from head to tail) development is the first trend, with the head and brain developing first, followed by the trunk, legs, and feet.

A nurse is working in the pediatric clinic. The nurse is seeing Janet Brent and her 10-year-old daughter, who is here for a well-child checkup. Janet asks what the common health problems are for this age. The nurse's correct reply includes which of the following?

Scoliosis

A 38-year-old male comes to the clinic for a routine visit. During the interview, the patient tells that nurse that he is really striving to make his family work better. He says, "I focused on gaining respect and making my life the best it can be." The nurse interprets this information applying the theory by Levinson as indicating which phase of development?

Settling down: building a second adult life structure

As the nurse is preparing an immunization for a male client 2 years of age, his mother discovers that he has soiled his underpants. She scolds him and calls him a "bad boy" because he "dirtied" his underwear. The nurse gives the immunization and provides some education to the mother about appropriate expectations for this age group. The nurse knows that according to Erikson's theory for this client's age group, he is at risk to develop which of the following?

Shame and doubt

During a well-child visit, the nurse observes a 3-year-old girl who climbs up into her father's lap and says, "I am going to marry you when I grow up, Daddy." What determination does the nurse make about this observation?

This child is experiencing the Electra complex which is normal at this age.

A nurse is assessing a 45-year-old male at a routine office visit. Applying Gould's developmental concepts, which finding would the nurse expect to assess? Select all that apply.

Acceptance of lifespan boundaries Belief that personalities are set Active participation in social activities

The nurse sees a client age 4 years and her mother at the pediatric clinic. The client is here for immunizations. She is bubbly and talkative, and tells you about her dance lessons and her new baby brother. Her mother tells you she encourages her daughter to try new experiences and enjoy life. You know that according to Erikson's developmental theory, the client is well on the way to achieving which of the following?

Initiative

A mother, 13 years of age, delivers a low-birth-weight neonate. The neonate is transferred to the neonatal intensive care unit. The mother reports receiving occasional prenatal care and has a history of excessive alcohol consumption. The growth and development of this neonate has been influenced by which of the following?

Prenatal factors

Genomic information can identify gene mutations and environmental influences that can impact a pregnancy. What are the implications for nursing practice related to this advancement?

Provision of appropriate health teaching Explanation: Regarding the ongoing genomic research, nurses need the knowledge base to be able to answer questions, provide appropriate health teaching, and counsel or direct patients at risk to available resources. The other choices are all good prevention interventions for nurses to teach pregnant patients, but not necessarily related to genomic research.

Donald, a newly graduated nurse is applying for a position in a pediatric clinic. In preparation, he studies about growth and development. He learns that which of the following are considered milestones within a developmental level? Choose all that apply.

Roll over Crawl Walk

The nurse is assessing a 15-year-old who was involved in a fight at school. Which client statements would the nurse see as evidence that this child is delayed in Erickson's developmental stages? Select all that apply.

"I do not trust anyone." "I am not good at anything." "I really don't have many friends, nobody likes me."

A 4-year-old client was admitted for treatment of severe pneumonia. The parents report that the child has been toilet-trained for two years, but the client has been incontinent of urine and stool twice since admission. How should the nurse explain this to the parents?

"Many children regress in their developmental stages when seriously sick."

A nurse is reviewing the medical records of several children who come to the health center for care. When applying Piaget's theory, which child would the nurse anticipate as being able to think abstractly and use deductive reasoning?

13-year-old

A nurse is providing care to several children at the local clinic. When assessing each child, in which child would the nurse expect to find the ability to think abstractly and use deductive reasoning?

13-year-old female

The nurse is caring for a boy 4 years of age who has gone through a painful surgery. During the hospitalization the child has been wetting his bed. The child's mother expresses dismay and anger, saying that her son has been toilet trained for over a year. The nurse needs to recall which of the following general principles of growth and development when responding to the mother?

Anticipate possible regression during difficult periods.

A 25-year-old client is a college graduate and is married with one child. During a wellness visit, the client confides, "I just feel like something is missing from my life. Maybe I need to make a career change." How would the nurse familiar with Levenson and associates' theory of development interpret this statement?

As a normal finding for a client at this stage of development.

A child who learns that he must sit quietly during story hour in kindergarten, thereby integrating this new experience into his existing schemata, is applying the process of:

Assimilation

What is considered to be a time when specific environmental or biologic events must occur for development to proceed normally?

Critical period A critical period is a time during which specific environmental or biologic events must occur for development to proceed normally.

A nurse is reviewing developmental theories for class discussion. The nurse knows that Freud's theory emphasizes the effect of instinctual human drives on behavior. He identified the underlying stimulus for human behavior as sexuality, which he called libido. Freud defined libido as which of the following?

General pleasure-seeking instincts

A nursing student is visiting a day care to observe growth and development in action. The nursing student completes screening assessments on preschoolers who are learning to feed, dress, and toilet themselves, as well as expanding their motor and verbal abilities. According to Piaget, in what development stage are they?

Preoperational Piaget's preoperational stage is characterized by the beginning use of symbols, through increased language skills and pictures, to represent the preschooler's world. Sensorimotor is Piaget's birth to 24-month stage. Concrete operational is Piaget's 7- to 11-year-old stage. Autonomy versus shame and doubt is Erikson's theory.

A nurse is caring for a 6-year-old boy who is hospitalized for observation following a motor vehicle accident. Based on Havighurst's developmental tasks, what would be the best choice for a diversional activity for this client?

Reading a storybook

The nurse is seeing a male client 6 years of age in the clinic. As the nurse is measuring height and weight for the client, his mother comments on how coordinated he is becoming. The nurse knows that this increase in coordination is which of the following?

Related to development

Newborns are capable of activities such as grasping objects and displaying basic reflexes. To which of the following of Piaget's cognitive developmental stages do the newborns belong?

Sensorimotor

A nurse is conducting an in-service education program for a group of nurses transitioning to the pediatric unit of the facility. The nurse is describing the various theories of growth and development. The nurse determines that the teaching was successful when the group identifies the stages of cognitive devleopment by Piaget. Place the stages listed below in the correct sequence from first to last that would demonstrate the group's learning.

Sensorimotor Pre-operational Concrete operational Formal operational

A nurse is observing a child pick up a rattler and shake it to hear a sound. The nurse understands that the child is considered to be in which of the following of Piaget's Cognitive Development stages?

Sensorimotor stage

A nurse assesses the effect of the environment and nutrition on clients visiting a walk-in clinic in a low-income community. Which statements accurately describe these effects? Select all that apply.

Substance use by a pregnant woman increases the risk for congenital anomalies in the developing fetus. Use of alcohol and drugs is more prevalent in teenagers who have poor family relationships. An increased incidence of teenage pregnancy can be linked to substance use by adolescents.

A nurse is caring for a toddler in a pediatric clinic. Based on the age of the child, the nurse understands the child should be in Piaget's Preoperational stage. Which of the following activities should the nurse anticipate observing in this stage?

The child rides a broom like a horse.

A nurse is presenting a workshop for a group of young women. Part of the workshop focuses on the moral development of women. The nurse integrates information about Gilligan's theory into the presentation, describing the various levels that a woman goes through as morality develops. When describing level 1, the nurse would focus on which area?

Woman's own needs

According to Havighurst, learning behaviors are based upon developmental tasks. In assessing an adult patient, the nurse is aware that a common developmental task of middle adulthood includes:

assisting children to become responsible adults.`

Based on Havighurst's theory, the nurse recognizes that one of the developmental tasks of middle adulthood is:

adjusting to physical changes.

According to Freud's theory, what factor is concerned with self-gratification?

Id

The nurse observes a hospitalized 15-year-old male refuse his meal tray and state: "I usually eat pizza at home. I can't eat the food in here." This type of rebellious behavior is characteristic of which of Erik Erikson's stages of psychosocial development?

Identity versus role confusion

A 10-year-old girl is excited when she receives the "most improved player" award on her softball team. Although she was not the strongest player on the team, she always tried to perform at her best level and never gave up on practicing her skills. What stage of psychosocial development according to Erik Erikson is this child demonstrating?

Industry versus inferiority

The parents of a 4-year-old girl bring the child to the clinic for the first time. During the assessment, the nurse asks the parents about any religious beliefs. The parents tell the nurse that they are Christian. The mother says, "We take her to church with us. She's really well-behaved. She even tries to imitate what we do, standing, kneeling, folding her hands, and such." The nurse interprets this behavior as reflecting which stage of faith development?

Intuitive-projective faith

The nurse is caring for a mother of a healthy infant age six months. The mother expresses concern about the child putting everything in his mouth. The nurse uses Freud's theory to teach the mother which of the following about this behavior?

It is a way that the infant explores.

The school nurse is teaching growth and development in a health class. What should the nurse teach the students about development?

It is the process of ongoing change

A nurse wants to teach children about the importance of oral health with brushing and flossing. Based on Piaget's theory, to what age group would it be most appropriate to teach this topic?

Third- and fourth-graders According to Piaget, children ages 7 to 11 learn by manipulating concrete or tangible objects and are developing logical thinking. This (third and fourth grade) would be an appropriate age to teach oral health.

According to Freud, which of the following influences is the primary force that drives an individual's development?

sexuality.

What are the two factors that drive growth and development?

Genetics and environment

A nurse is teaching parents of preschoolers about growth and development of their children. Which teaching point would the nurse include?

The pace of growth and development is specific for each person.

A pediatric nurse practitioner is assessing the development of a child. The nurse's assessment of development will focus on which of the following?

Changes in thoughts, feelings, and behaviors

A nurse is caring for a pediatric client on an oncology unit. The family has asked that faith be included in developing the plan of care. Which belief's would be included according to Fowler's Theory of Faith Development? Select all that apply.

Children imitate religious behaviors of others. Courage, hope, and love compete with threats of abandonment. The synthetic stage is seen as conventional faith demonstrated by young adults becoming responsible for their own beliefs.

Which of the following actions should a nurse take in order to apply theories of development into nursing care?

Choose outcomes that are reflective of clients' developmental stages

A nurse is working with a child on a pediatric unit. Based on the age of the child, the nurse understands the child should be in Piaget's Concrete Operational stage. Which of the following activities should the nurse plan to include in the plan of care to evaluate if the child has achieved this stage?

Classifying and sorting coins

A nurse is assessing a 7-month old infant. When applying Piaget's theory of cognitive development, which developmental task would the nurse expect the infant to have achieved? Select all that apply.

Demonstrating basic reflexes such as sucking Performing repetitive behaviors such as smiling Relating behavior to a change in the environment The child is in the sensorimotor stage according to Piaget. This stage is marked by progression through a series of six substages with specific developmental tasks: 0 to 1 month—demonstrates basic reflexes, such as sucking; 1 to 4 month—discovers enjoyment of random behaviors (such as smiling or sucking thumb), and repeats them; 4 to 8 months—relates own behavior to a change in environment, such as shaking a rattle to hear the sound or manipulating a spoon to eat; 8 to 12 months—coordinates more than one thought pattern at a time to reach a goal, such as repeatedly throwing an object on the floor; only objects in sight are considered permanent; 12 to 18 months—recognizes the permanence of objects, even if out of sight; can understand simple commands; 18 to 24 months—begin to develop reasoning and can anticipate events.

A student nurse is assisting the school nurse with a health fair at a middle school. The student nurse assesses the students' heights and weights as they file through the station, observing that there is a large variation in physical size and emotional maturity. Which of the following factors may affect emotional growth of children? Choose all that apply.

Development of trust Praise for doing well Loving caregivers

A nurse is caring for an elderly client in a long term care facility. The resident is reminiscing about his life and his achievements. The nurse understands the client is in which of the following stages of Erik Erikson's Psychosocial Development theory?

Ego Integrity

An older adult has come to the clinic for a follow up visit. During the visit, the client tells the nurse, "I've really had a good life. I've been successful in my work and I have a wonderful family. My grandchildren bring me so much joy." The nurse interprets this statement as indicating achievement of which developmental task?

Ego integrity

The nurse is caring for a man 79 years of age who was admitted for a hip replacement. He visits with the nurse every chance he gets; he seems lonely. He tells the nurse his wife died two years ago. He has children in nearby cities and has nine grandchildren. He says his life has been good and he is content, even though he misses his wife. The nurse assesses him for developmental issues and knows that he fits well into which of Erikson's stages of development?

Ego integrity versus despair Later adulthood brings either ego integrity or despair, according to Erikson. As one enters the older years, reminiscence about life events provides a sense of fulfillment and purpose. If one believes that one's life has been a series of failures or missed directions, a sense of despair might prevail. Generativity versus stagnation involves the middle years and intimacy versus isolation is about young adulthood. Mental health versus instability is not part of Erikson's theory.

A nurse is observing interactions between a new mother and her newborn. The nurse observes the mother not responding to her newborn's cries. Which of the following growth and development theories does the nurse understand this observation addresses?

Erik Erikson's Trust vs Mistrust stage

Which developmental theorist created the psychosocial theory of development?

Erikson

A nurse observes individuals who are volunteering in a community free health clinic. Which of the following stages of Erikson's Psychosocial Development theory describes these individuals?

Generativity vs stagnation

Donald, a newly graduated nurse, is working in a pediatric clinic. Today he sees Karen, a 1-month-old infant, and her single mother. The mother is estranged from Karen's father but is marrying her high school sweetheart next week. Donald remembers from nursing school that which of the following will affect an infant's growth and development? Choose all that apply.

Genetics of mother Environment of infant Mother's prenatal nutrition

A nurse is reading a journal article about growth and development. The article goes on to describe the concept of transformation. The nurse demonstrates understanding of the information by identifying which theorist as being identified with this concept?

Gould

The nurse is seeing 6-year-old Patrick in the clinic. As the nurse is measuring height and weight for Patrick, his mother comments on how much he has grown since his last checkup. The nurse knows that this increase in size is which of the following?

Growth

A student nurse is assisting the school nurse with a health fair at a middle school. The student nurse assesses the students' height and weight as they file through her station, where she observes that there is a large variation in physical size and emotional maturity. Which of the following factors may affect physical growth of children? Choose all that apply.

Heredity Prenatal nutrition Physical activity

A boy 8 years of age is looking at his father's razor and shaving cream in the bathroom medicine cabinet. He watches his father shave daily and asks his father when he will need to start shaving. This child is demonstrating characteristics common during which of Freud's psychoanalytic developmental stages?

Latency stage

The nurse is caring for a woman 68 years of age who is admitted for fixation of an ankle fracture related to a fall at home. The client states that she is thinking of selling her home and moving to a smaller place. Her husband died six months ago and she is unable to physically maintain her home without him. She sounds accepting of this. According to Robert Havighurst, in which of the following developmental stages is the client?

Later Maturity

A nurse is working with young adults and assessing their moral development. The nurse relates which of the following theorists who developed the Theory of Moral Development?

Lawrence Kohlberg

The nurse is counseling a woman who states: "I'm never going to find a husband; every time I start dating I end up getting hurt. I'm not even going to try anymore." This woman is in what stage of Carol Gilligan's theory of moral development?

Level 1—selfishness

The nurse is providing prenatal education for a group of pregnant teenagers. The nurse talks about substance use during pregnancy and relates that use to which possible newborn consequences? Select all that apply.

Low birth weight Premature birth Congenital anomalies

According to Kohlberg, which of the following considerations is central to human development?

Morality

A nurse is conducting an in-service education program on moral development for a group of staff nurses. The nurse describes the theories of Kohlberg and Gilligan. The nurse determines that the teaching was successful when the group identifies which area as being associated with women and morality?

Needs of others

As a nursing student is visiting a day care to observe growth and development in action. The nursing student completes assessments on infants and toddlers who are learning to walk, talk, and control elimination. According to Freud, in what developmental stage are they?

Oral; Anal

A student nurse is enrolled in a growth and development class. Which of the following Freudian stages should the student nurse recognize in a child with an increase in gender difference awareness?

Phallic Stage

An resident of a long-term care facility, age 82 years, often tells stories of the role that he played in the Korean War. According to Erikson, which of the following needs may underlie the resident's storytelling?

The need to demonstrate that his life was meaningful and purposeful